TY - JOUR
T1 - The challenges of linking health insurer claims with electronic medical records
AU - West, Suzanne L.
AU - Johnson, William
AU - Visscher, Wendy
AU - Kluckman, Marianne
AU - Qin, Yue
AU - Larsen, Ann
N1 - Funding Information:
The research presented in this article was funded by RTI International.
PY - 2014/3
Y1 - 2014/3
N2 - This article explores the challenges inherent in linking data from disparate sources - electronic medical records (EMR) and health insurer claims - and the probable benefits of doing so to evaluate several quality measures associated with diabetes. Using the business associate agreement provision of the Health Insurance Portability and Accountability Act, we were able to link health insurer claims with EMR data; however, when restricting the linked data to patients with at least one medication and one diagnosis in the evaluation year, we lost 90 percent of our linked population. Whether this loss was due to difficulties in extracting the data from site EMRs, to changes in insurer coverage over time, or to both was not discernible. Because linking EMR data to health insurer claims can produce a clinically rich longitudinal data set, assessing the completeness and quality of the data is critical to health services research and health-care quality measurements.
AB - This article explores the challenges inherent in linking data from disparate sources - electronic medical records (EMR) and health insurer claims - and the probable benefits of doing so to evaluate several quality measures associated with diabetes. Using the business associate agreement provision of the Health Insurance Portability and Accountability Act, we were able to link health insurer claims with EMR data; however, when restricting the linked data to patients with at least one medication and one diagnosis in the evaluation year, we lost 90 percent of our linked population. Whether this loss was due to difficulties in extracting the data from site EMRs, to changes in insurer coverage over time, or to both was not discernible. Because linking EMR data to health insurer claims can produce a clinically rich longitudinal data set, assessing the completeness and quality of the data is critical to health services research and health-care quality measurements.
KW - EMRs
KW - Electronic medical records
KW - Health Information Technology for Economic and Clinical Health Act (HITECH)
KW - Health Insurance Portability and Accountability Act (HIPAA)
KW - Patient Protection and Affordable Care Act (PPACA)
KW - health insurer claims
KW - linkage
UR - http://www.scopus.com/inward/record.url?scp=84894458093&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84894458093&partnerID=8YFLogxK
U2 - 10.1177/1460458213476506
DO - 10.1177/1460458213476506
M3 - Article
C2 - 24550563
AN - SCOPUS:84894458093
SN - 1460-4582
VL - 20
SP - 22
EP - 34
JO - Health informatics journal
JF - Health informatics journal
IS - 1
ER -